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Racial Bias in Medicine

Racial bias in medicine is still an issue, and $10 million in medical grants are meant to help fight it.

The Doris Duke Charitable Foundation is the legacy of one of America’s wealthiest women. Doris Duke, who passed in 1993 at the age of 80, was a tobacco heiress and an active socialite. During her life, she used her considerable wealth to preserve historical buildings and threatened heritage strains of certain plants. She also funded AIDS research, child welfare programs, and the education of black students in the south. The Doris Duke Charitable Foundation is dedicated to medical research, performance arts, and environmental justice at her direction.

Since the 1970s, physicians, especially in emergency medicine and OB/GYN care, have used medical assessment tools and algorithms. Plug a few stats and details into an equation, and get back a recommended course of care. These tools look at many factors, including race. Race as a component of medical decisions is sometimes important, but these tools have gone unquestioned from the 1970s until 2016.

A study found that a kidney-function calculator adjusted measurements for Black patients to a degree that made them more likely to be considered eligible for transplant lists, literally costing lives. Another calculator produced worse odds for Black and Hispanic women of having successful vaginal deliveries after C-sections, exposing those women to unnecessary surgery and expenses.

This kind of racial bias is what the Doris Duke Foundation donations are meant to address. They’ll be given to five health organizations to help study the effects of racial bias in specific diagnostic tools and rewrite them to help eliminate it.

“Race is not a biologic proxy,” says Joseph Wright, the incoming chief health equity officer for the American Academy of Pediatrics. “Race is a social construct and has no place being embedded in a clinical guideline like this.” He and his researchers will be revising a calculation that led to missed diagnoses of urinary-tract infections in Black children.